MEDICARE: ANGELIQUE MARIE BECKER PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	118678	MN

General Provider Information

NPI Number	:	1992772040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELIQUE MARIE BECKER PHARMD

Provider Business Mailing Address
First Line	:	6947 224TH AVE NE
Second Line	:
City	:	STACY
State	:	MN
Zip	:	55079-9375
Country	:	US
Telephone Number	:	612-262-5985
Fax Number	:	612-262-5988

Provider Business Practice Location Address
First Line	:	2545 CHICAGO AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-4522
Country	:	US
Telephone Number	:	612-863-5810
Fax Number	:	612-863-5702

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	02/01/2024

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